Dr. Hughey discusses the evolution of his 10 minute video lecture on common bleeding problems.
Originally developed for the Navy, the lecture developed into a civilian version, and ultimately a video lecture for students.
He also discusses the technical aspects of the lecture, exactly how it was produced, and finally his evaluation of its strengths and weaknesses.
Behind the Scenes
Original Common Bleeding Problems Video
Behind the Scenes Script
The origins of this lecture go back to my Navy days, when I was involved in providing advanced training to physicians, nurses and hospital corpsmen.
In the 1990’s, women were first being deployed to ships and other remote locations in large numbers. Part of the preparation for this change in policy involved training the healthcare providers in the provision of women’s healthcare.
Of course, most women’s healthcare is the same as men’s healthcare, but some of it was unique. As a Navy Reserve OBGYN, and medical school instructor, I was asked to help with this training.
One of the training modules I developed dealt with abnormal bleeding. That’s a pretty broad topic, but I was able to condense it with some restrictions.
First, I didn’t need to cover all ages, just otherwise healthy women of childbearing age, primarily between 18 and 35. This corresponded to the Navy population.
Second, I didn’t need to explain all the background pathophysiology, just enough detail to enable someone with minimal OBGYN training to effectively deal with 95% of the problems they might encounter in a remote setting.
Last, my focus was on fixing those problems that can be easily fixed, and knowing which problems required further care, either delayed, when the ship returned to port, or immediate, meaning a potentially dangerous medical evacuation from a ship.
I settled on five clinical issues:
Heavy or lengthy periods
Very light periods
Delayed or absent periods
Too frequent periods
Constant bleeding
Then, I worked out the methods for resolving them, using only the medications and resources that would typically be available on a ship or in a remote location. Fortunately, pregnancy tests and birth control pills are readily available in those settings.
I tried to identify danger signs that could indicate a more serious problem, requiring urgent medical evacuation. I also worked out temporizing management, in the event medical evacuation was not immediately available.
These guidelines proved to be useful to the Navy, and so I later adapted them to civilian use, focusing on the introductory level of women’s healthcare. This was in written format and included in my website, OBGYN 101.
Several years later, I decided to build a new website that would simulate a medical student’s 3rd year rotation in OBGYN. I called it OBGYN Morning Rounds. In addition to rounds, surgery experience, and clinic experience, I wanted to include some Afternoon Lectures.
It seemed like every medical school I had any connection with had lectures built in. Some were focused on a specific day (Friday, for example); Others, a particular time of day. Afternoon lectures seemed like a good mechanism for conveying this information to the students.
This being one of my later videos, I was accustomed to applying all of the science of how students learn best off of screens to build the video.
I started with a script and recorded it in my basement studio, using good quality audio recording equipment and my own voice.
I post processed the audio using the free program Audacity by normalizing the volume. This meant that everything was the same volume, even when I accidently moved my lips a little further from the microphone.
I removed background noise with Audacity by recording a few seconds of background noise, and then electronically removing it from the voice track.
I electronically silenced the spaces between sentences (so no one would hear me taking a breath), and began the content editing process. I needed to remove the false starts, coughs, and misspoken words.
For pacing, I listened to a few sentence breaks, and then made all of the sentence breaks the same duration. The exception would be whenever I changed topics, and then I’d make the sentence break longer.
Once all the voice editing was completed, I’d use the sound track as the basis for my video, adding images that would accompany the things I was discussing.
I used a black background, to avoid visual distractions, and plain white block lettering for my bullets.
I tried to always use very simple drawings or diagrams to illustrate my points.
I added the opening title images, using my standard classroom image, with my picture gradually superimposed, to serve as the recognizable avatar or guide for the topic. I used the same imagery at the end of the lecture, in reverse order, to close out the course.
The consequence of these efforts was a 10 minute lecture that covered the breadth of one of the most common and important clinical issues in gynecology.
The duration was longer than I wanted. I prefer 5 minute videos as being more tolerable. But some topics can’t be covered effectively in 5 minutes, and this is one of them.
I think there are some good things and some bad things about this video.
One good thing is that for students who tune in, listen to every word, and focus their eyes on the screen for 10 minutes, they will learn a lot, and retain that knowledge.
Another good thing is that the lecture is very practice-based. How do you take care of patients with these problems.
While I provide some physiologic basis with the explanations, the focus is on basic patient care techniques. It’s very practical.
One bad thing is that it’s too long for many students to comfortably sit through. It’s length is a necessity because of the topic, but that doesn’t mean I’m happy about it.
Another bad thing is that it’s too thin on drawings and diagrams. Students engage easily when shown a drawing that shows spatial or temporal relationships, while a calm voice is explaining what they are seeing. It’s harder for the students to stay engaged when there are only bullet points that track what the voice is saying.
It would be a better lecture, a more effective lecture, if there were more drawings and diagrams.